Let's take a look at Autoimmune
diseases that affect the liver.
It is important that you
pay attention to each one of these
Each one will be presenting a little
bit differentially and
when it is time for you to indentify
this particular autoimmune disease
or certain markers,
then they will become important for you.
One differential for
chronic liver disease of autoimmune,
nature will be of
And I'll give you the markers there.
Keep in mind
that these individuals with autoimmune
have not touched a drop of alcohol
in their entire life.
And most likely a female.
Auto immune diseases.
Primary biliary cirrhosis is
another disease causing
damage to the liver,
What I like for you to do next
is think about diseases that will be
taking place within the liver
and you can call these
Or you are referring to diseases
coming out of the liver
Thus, extra hepatic, right?
Whenever you come out of the liver,
the organ system that you have
immediately enter into
will be the biliary system.
So, any time you hear an attending
physician or you are reading a case,
and it says either inter hepatic
or extra hepatic diseases
Then you know exactly as to what component
of the hepatic biliary system
has been affected.
With primary biliary cirrhosis,
where does your biliary system
In the liver,
you've heard of a caniliculi
And at some point,
when all of the caniliculi have come
And you've moved towards
Zone 1. Yes, you heard that correctly.
zone 1, which contains your portal triad.
And of the triad, you are dealing
with your bile duct
Then from there, you are going to leave
your liver extrahepatic
and start forming a biliary tree.
And it is important,
I give you primary biliary cirrhosis
I give you auto mitochondria bodies
all play a huge role there.
We have another autoimmune
disease but this is affecting more
more so your biliary trees.
And that is where your focus should be.
Outside of the liver,
This is called primary.
But this time it's sclerosing.
What does sclerosis means to you?
What is narrowing
in primary sclerosing cholangitis?
Not the blood vessel.
It is the bile duct. Cholangeo means what
The biliary tree.
You will be focusing upon
what's known as TSC
and I'll give you more of their code.
P and K.
It means to say that if you have
autoimmune disease and it is causing
damage to your liver, you have every
that this autoimmune disease
to the biliary tree.
Sarcoidosis have being
here with the liver.
I thought Sarcoidosis is only dealing
with the lungs Dr. Raj?
No, don't that anymore.
You've heard of lung case of
* Sarcoidosis, everyone has.
Your patient will be most likely
young African-American female
but the *glenalloma could
be in number of places.
Yes, it could be in the lung,
But the * glanaloma can also be found
in the skin perhaps.
Or maybe down in the
causing liver disease maybe perhaps
causing autoimmune nature.